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Congress’ ‘Disarray’ Makes It ‘Likely’ that 27% Medicare Cut Will Go Into Effect

When Will Congress Put an End to Recurring “SGR Nightmare?” Internists Ask

December 19, 2011

Washington: Congress’ “disarray and dysfunction” jeopardize access to medical care for many millions of seniors, disabled persons, and military families, said the American College of Physicians (ACP) in a statement released today and shared with House and Senate leadership. ACP is the largest physician specialty society—and second largest physician membership organization—in the United States, representing 132,000 internal medicine specialist physicians and medical student members.

Just 13 days remain before payments for physician services to Medicare and TriCare patients will be cut by 27.4 percent, yet Congressional efforts to prevent the cut, caused by Medicare’s Sustainable Growth Rate (SGR) formula, are in complete disarray.

Last week the House passed a bill, as part of a broader “extenders” package, to prevent the Medicare cuts for two years, replacing them with a small positive update. The House bill, though, included budget offsets and policy riders that were unacceptable to the Senate and White House. On Saturday, the Senate passed a short-term patch, as part of its extenders bill, which would have extended current Medicare payment rates for only two months. Today, the leadership of the House of Representatives stated that the Senate bill is unacceptable, and that it instead would seek an agreement on a year-long extension of Medicare payment rates and other expiring provisions. Yet the House has not presented a plan to resolve its differences with the Senate and the White House, and with the Senate already on recess, there is no clear path forward that would allow Congress to act before the 27.4 percent cut goes into effect on January 1.

“With each passing day, it appears more likely that Congress will just allow the 27.4 percent cut to go into effect, despite lawmakers’ repeated promises all year that they would prevent it,” said Dr. Virginia Hood, ACP’s president. “Most physician practices are small businesses, and they can’t stay open for business as usual if Medicare doesn’t cover their practice costs. Physicians will have to make very difficult—and painful—choices such as closing their practices, laying off staff, or limiting how many patients they can see, choices that will be foisted upon them by Congress’ irresponsibility.”

ACP reiterated its call for Congress to enact legislation to prevent the January 1 cut, but also explained that ACP cannot get behind another short-tem patch that leaves the underlying SGR formula in effect.

“Instead of replaying the tired old script of arguing over whether the cut should be delayed for two months or two years, or something in between, Congress must do the right thing and enact a permanent solution,” Dr. Hood continued. “At Congress’ request, ACP and other physician organizations have put forward concrete proposals to eliminate the SGR, stabilize payments, support the value of primary care, and transition to new patient-centered care and delivery models, and ACP even gave Congress proposals to help pay for it. When will Congress do its part and join with us to develop a bipartisan plan to end the recurring SGR nightmare?”

The American College of Physicians (www.acponline.org) is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 132,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection, and treatment of illness in adults. Follow ACP on Twitter and Facebook.